Academic literature on the topic 'Basic health care'

We studied the frequency of jaundice, bilirubin estimations, phototherapy administration and exchange transfusions performed at 5 year intervals (1981, 1986 and 1991) among babies admitted to special care unit and those managed in postnatal ward, showing a decline which was significant except for the number of exchange transfusions performed. The number of term babies with serum bilirubin >15 mg/dl and preterm babies with serum bilirubin > 10 mg/dl also declined significantly without prophylactic phototherapy or pharmacotherapy.

Pregnancy challenges the health care system in a unique way in that it involves at least two individuals – the woman and the fetus. The death rates of both pregnant women (maternal mortality) and newborns (perinatal mortality) are often used to indicate the quality of care the health system is providing. In terms of maternal and perinatal outcomes South Africa scores poorly compared to other upper-middle income countries (Penn-Kekana & Blaauw, 2002:14). The high stillbirth rate compared to the neonatal death rate reflects poor quality of antenatal care. Maternal and perinatal mortality is recognised as a problem and as a priority for action in the Millennium Development Goals (Thieren & Beusenberg, 2005:11). The Saving Mothers (Pattinson, 2002: 37-135) and Saving Babies (Pattinson, 2004:4-35) reports describe the causes and avoidable factors of these deaths with recommendations on how to improve care. The quality of care during the antenatal period may impact on the health of the pregnant woman and the outcome of the pregnancy, in particular on the still birth rate. In primary health care services there are many factors which may impact on and influence the quality of antenatal care. For example with the implementation of the comprehensive primary health care services package (Department of Health, 2001a:21-35) changes at clinic level resulted in a large number of primary health care professional nurses having to provide antenatal care, who previously may only have worked with one aspect of the primary health care package such as minor ailments or childcare. Because skills of midwifery or antenatal care, had not been practiced by some of these professional nurses, perhaps since completion of basic training, their level of competence has declined, and they have not been exposed to new developments in the field of midwifery. The practice of primary health care nurses is also influenced by the impact of diseases not specifically related to pregnancy like HIV/AIDS and tuberculosis. The principles of quality antenatal care are known (Chalmers et al. 2001:203) but despite the knowledge about these principles the maternal and perinatal mortality remains high. The Basic Antenatal Care quality improvement package is designed to assist clinical management and decision making in antenatal care. The implementation of the BANC package may influence the quality of antenatal care positively, which in turn may impact on the outcome of pregnancy for the mother and her baby. The aim of this study was to evaluate the effectiveness of the Basic antenatal care (BANC) package to improve the quality of antenatal care at primary health care clinics.

Henry Shue’s model of basic rights and their correlative duties provides an excellent framework for analysing the requirements of global distributive justice, and for theorising about the minimum acceptable standards of human entitlement and wellbeing. Shue bases his model on the claim that certain ‘basic’ rights are of universal instrumental value, and are necessary for the enjoyment of any other rights, and of any ‘decent life’. Shue’s model provides a comprehensive argument about the importance of certain fundamental goods for all human lives, though he does not consider health or health care in any significant detail. Adopting Shue’s model, I argue that access to health care is of sufficient importance to the enjoyment of any other rights that it qualifies as what Shue describes as a ‘basic’ right. I also argue that the basic right to health care is compatible with the basic rights model, and is required by it in order to for it to achieve its goal of enabling right holders to enjoy any decent life. In making this claim I also explore the requirements of the basic right to health care in terms of Shue’s triumvirate of duties and with reference to several key examples.

The present study was undertaken to provide an understanding of the processes underlying health visiting practice. The research strategy selected was grounded theory (Glaser and Strauss 1967, Strauss 1987, Strauss and Corbin 1990). A total of 21 female health visitors from a District Health Authority in the North West of England participated in the study. Data was collected by means of 20 formal interviews and 41 days of participant observation in four different health centres. To recognize the basic social process in any interaction is one of the major aspects of grounded theory. This requires the identification of the "Phenomenon" which motivates the development of a process and the conditions under which it operates. The basic problem or phenomenon in health visiting uncovered in the data was "Securing Life Trajectories". This forms the core of the health visitor's work. The general set of conditions that influence health visiting work was identified as "Working Between Two Worlds". This is used to describe the health visitor's position between the policy agenda and the client's agenda. The process revealed in the data that health visitors use to respond to this overall problem was "Marketing Health Visiting". This refers to the different tactics that they use to introduce the policy agenda into the client's domain. During this process the policy agenda is adjusted to fit the client's circumstances. Three major strategies are identified in this process: 1) Promoting the service, 2) Adjusting delivery and 3) Tailoring the content. This study found that "Marketing Health Visiting" is a gradual process in which the health visitor wins grounds as time passes. As marketing strategies are implemented the conditions influencing the interaction change. Hence it moves from taking place in what is labelled in this study as "Dissociated Context", to a "Convergent Context" and finally to a "Shared Context". The final consequence of implementing marketing strategies is that of constructing "A Common Agenda" with clients. This agenda is basically the personalisation and contextualization of health visiting services. To build this common agenda it is of crucial importance that the client should see and feel the need for the health visiting service as well as the development of trust between the professional and the client. Hence the relationship that is developed between them acts as an enabling factor for reaching mutual collaboration. The discussion of the study focuses on its significance within the actual debate on health visiting about introducing new ways of practice. The health visitor's overall role is examined and the importance of developing relationships with clients is also highlighted.

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The 'Mais Médicos' Program was launched by the federal government in 2013 with the main objective of reducing the shortage of physicians in regions of socioeconomic vulnerability in Brazil. Since then, the program has been attracting interest in evaluating its effectiveness on the localities adhered. This paper aims to measure the effects generated by the 'Mais Médicos' Program on health indicators of Brazilian municipalities from an econometric approach of policy evaluation. Using a difference-in-differences methodology, the effects on indicators of basic health care, morbidity and mortality were analyzed from the Program data between 2013 and 2015. There are evidences that the 'Mais Médicos' Program has positive effects on the primary healthcare indicators, particularly on appointments, consultations, referrals, examinations, and home visits, and negative effects over some indicators of morbidity. However, the Program does not seem to have been able to reduce mortality in the municipalities.
O Programa Mais Médicos foi lançado pelo governo federal em 2013 e seu objetivo principal é reduzir a escassez de médicos em regiões de vulnerabilidade socioeconômica no Brasil. Desde então, o programa vem atraindo interesse em avaliar sua efetividade sobre as localidades aderidas. Este trabalho se propõe a medir os efeitos gerados pelo Programa Mais Médicos sobre indicadores de saúde dos municípios brasileiros a partir de uma abordagem econométrica de avaliação de políticas. Empregando uma metodologia de diferença em diferenças, foi analisado o efeito sobre indicadores de atendimento básico de saúde, de morbidade e de mortalidade a partir de dados do Programa de 2013 a 2015. Existem evidências de que o programa 'Mais Médicos' tem efeitos positivos sobre os indicadores de atendimento básico de saúde, particularmente em atendimentos, consultas, encaminhamentos, exames e visitas, e efeitos negativos sobre alguns indicadores de morbidade. No entanto, o Programa não parece ter conseguido reduzir a mortalidade nos municípios.

Background Uganda lacks formal emergency care training programs to address its high burden of acute illness and injury. The Ugandan Ministry of Health (MoH) rolled out the World Health Organization’s (WHO) Basic Emergency Care (BEC) course, the first openaccess short course to provide comprehensive basic emergency training for health workers in low-resource settings. The BEC and its new online cases both require further evaluation. Aim and Objectives The study aimed to assess the BEC course and online cases’ impact with the following objectives: 1. Determine participants’ knowledge acquisition and self-efficacy in emergency care. 2. Evaluate BEC participants’ perceptions of the course and online cases. 3. Assess the online cases’ impact on participants’ knowledge and self-efficacy in emergency care. Methods Mixed methods design explored the BEC’s impact. MCQs and Likert scales assessed knowledge and self-efficacy, respectively, among 137 participants pre-BEC, post-BEC and six-months post-BEC using mixed model analysis of variance (ANOVA). FGDs assessed perceptions of the course and online cases post-BEC and six-months postBEC among 74 participants using thematic content analysis. Results Participants gained and maintained significant increases in MCQ averages and Likert scores. The pre-course cases group scored significantly higher on the pre-test MCQ than controls (p=0.004) and found cases most useful pre-BEC. Nurses experienced more significant initial gains and long-term decays in MCQ and self-rated knowledge than doctors (p=0.009, p< 0.05). Providers valued the ABCDE approach and reported improved emergency care management post-BEC. Resource constraints, untrained colleagues and knowledge decay limited the course’s utility. Conclusions Basic emergency care courses for low-resource settings can increase frontline providers’ long-term knowledge and self-efficacy in emergency care. Nurses experience greater initial gains and long-term losses in knowledge than doctors. Online adjuncts can enhance health professional education in LMICs. Future efforts should focus on increasing trainings and determining the need for re-training.

Orientador: Rosana Onocko Campos
Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas
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Resumo: Na presente investigação realizamos uma análise sobre a organização das ações de saúde mental na rede básica de saúde de Campinas (SP), a partir da implantação do arranjo de gestão denominado Apoio Matricial. Esse arranjo visa disparar a ampliação da clínica das equipes interdisciplinares de saúde e reorientar a demanda para a saúde mental Desviando a lógica de encaminhamentos indiscriminados para uma lógica da co-responsabilização, ele pretende produzir maior resolutividade à assistência em saúde. Realizamos grupos focais com profissionais de saúde mental, das Equipes de Referência e gestores, e procuramos, sob a ótica da abordagem hermenêutica-crítica, encadear suas principais linhas argumentativas de modo narrativo, a fim de combinar a análise com a construção de sentidos para o material produzido. Após essas construções narrativas, produzimos uma meta-narrativa, conectando os diferentes enredos e vinculando-os ao contexto histórico-social da saúde mental e da saúde coletiva. Pretendemos, com isso, contribuir para que as discussões geradas pelos profissionais possam ser significadas no interior das transformações politicas e assistenciais na área da saúde mental. Palavras-chave: saúde mental, atenção básica à saúde, apoio matricial, gestão.
Abstract: By means of the present study, we analyzed the organization of mental health actions in the basic health network of the city of Campinas (SP), from the implantation of arrangements for the management called Matricial Support. These arrangements aim to advance the enlargement of the clinic of health interdisciplinary teams and reorient the demand for mental health. By deviating the logic of indiscriminate referrals to the logic of co-responsibility, it intends to produce a larger solvability to health assistance. We created focal groups with mental health professionals, from reference teams and managers, and we searched for, under the optics of the hermeneutic-critical approach, an interrelation of their main argumentative lines in a narrative way, with the purpose of combining the analysis with the construction of meanings for the material produced. After these narrative constructions, we produced a narrative goal, linking the different plots and joining them to the social-historical context of mental health and collective health. With that, we intended to contribute so the discussions generated by the professionals may be signified in the interior of political and assistance transformations in the area of mental health. Key-words: mental health, basic health care, matricial support, management.
Mestrado
Saude Coletiva
Mestre em Saude Coletiva

Basic Antenatal Care (BANC) is a way of training or upgrading the knowledge and skills of all nurses, midwives and doctors involved in antenatal care at the primary health care level so that the minimum care can be provided effectively. This study was conducted to investigate the implementation of the BANC program by midwives in the Mdantsane clinics during February 2009. Methods: A descriptive study design was undertaken targeting midwives providing antenatal care to pregnant women, in 14 clinics of Mdantsane. Data was collected from 25 midwives in the clinics, and from 140 ANC cards of women attending ANC on the day of their visit to the clinic. Results: The majority of midwives providing BANC in Mdantsane clinics were not trained in BANC. There were 10 trained midwives and 15 not yet trained. A total of twenty five midwives were involved in the study. The number of visits according to the BANC schedule was well known by the midwives in the study. The content of the visits was well known for the first visit, but for subsequent visits, the participating midwives could not state exactly what they do on these visits. They perceived BANC as something beneficial for both midwives and pregnant women with 24 of the participating midwives rating BANC as advantageous. In completing an ANC card, the midwives scored between 48 percent and 100 percent. Under examination, they scored between 52 percent and 100 percent. Lastly on interpretation and decision making, they scored between 0 percent and 92 percent. This could have troubling consequences for the health status of the mother and baby. Weaknesses in providing antenatal care identified in the study included participating midwives failing to fill in the last normal menstrual period (LNMP) and the estimated date of delivery (EDD), which was a worrying observation. Plotting of the gestational age at first visit was also not carried out well as only 47 percent of the midwives in the study did this, meaning that there would be a miscalculation of the gestational age thereafter throughout the pregnancies. The body mass index (BMI) was not calculated as the maternal height and weight were not written on the ANC card. This should be completed in order to check the nutritional status of the pregnant woman to help supplement, if malnourished, and educate on diet, if overweight. Only 17 percent of the midwives in the study plotted the foetal presentation. Failure to plot foetal presentation could lead to complications during delivery because women with abnormal presentations could end up delivering in a clinic instead of the hospital.Conclusion: This study showed that even though midwives are implementing BANC among pregnant women, it is not being carried out correctly. Therefore the programme will not be as beneficial as it would be if put into practice correctly. This is highlighted by the lack of knowledge from the untrained midwives regarding the content of care on subsequent visits. Thus there is an urgent need for BANC training to be conducted and monitored at various sites.

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In 2014, CBO reported health care expenditures consumed nearly 10 percent of the overall defense budget in 2012, up from 4 percent in 1990. Jansen, of the Congressional Research Service, noted in 2014 that moral hazard is considered one of the drivers of these increased costs; moral hazard results from lower out-of-pocket expenses. Adjustments to the administration of health benefits within DOD may reduce the DHP budget. Implementation of a basic allowance for health care (BAHC) for active duty dependents and retirees to use with a high deductible health plan (HDHP) and health savings account may provide incentives to use more cost-effective levels of care. The price elasticity of demand for health care is used to determine potential savings as the result of increased costs associated with the HDHP. The implementation of a BAHC is also examined from the point of view of the beneficiary to evaluate how they might respond to the changing incentives. This research found that while the plans are likely to invoke behavioral responses among beneficiaries and reduce moral hazard, unless they are widely adopted throughout the DOD they are unlikely to generate substantial cost savings as a percentage of current levels of spending.

ABSTRACT Background: Among the leading causes of global child morbidity and mortality are vaccine-preventable diseases, especially in low-and middle-income countries (LMICs). A complete basic immunization for children contains one BCG, three DPT-HB-Hib immunizations, four polio immunizations, and one measles immunizations. Antenatal care visit contributes an important to complete the basic immunization. This study aimed to estimate the effect of antenatal care on the completeness of basic immunization in children aged 12-23 months in Africa using meta-analysis. Subjects and Method: A meta-analysis and systematic review was conducted to examine the effect of antenatal care on the basic immunization completeness in children aged 12-23 months. Published articles in 2015-2020 were collected from PubMed and Google Scholar databases. Keywords used “immunization coverage” OR “vaccination coverage” OR “complete immunization” OR “complete vaccination” OR “full immunization” OR “full vaccination” AND children OR “child immunization” OR “child immunization coverage” NOT “incomplete immunization” OR “incomplete vaccination”. The inclusion criteria were full text, in English language, and using cross-sectional study design. The selected articles were analyzed by Revman 5.3. Results:6 studies from Senegal, Nigeria, Ethiopia, and South Africa showed that antenatal care increased basic immunization completeness in children aged 12-23 months (aOR=1.19; 95% CI= 1.06 to 1.36; p<0.001) with I2 = 95%). Conclusion: Antenatal care increases basic immunization completeness in children aged 12-23 months. Keywords: basic immunization, antenatal care, children aged 12-23 months Correspondence: Farida. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutarmi 36A, Surakarta 57126, Central Java. Email: faridariza9232@gmail.com. Mobile: 085654415292 DOI: https://doi.org/10.26911/the7thicph.03.125

Introduction: Parkinson’s disease (PD) is a neurological disorder that affects the dopamine-producing neurons and affects the patient’s movements. According to the World Health Organization, about 1% of the world’s population aged 65 years or older has PD. The study aims to analyze the hospitalizations for Parkinson’s disease in Brazil and highlight the importance of primary health care (PHC) in the care of these patients. Methods: This is an integrative literature review, using articles from the Pubmed and Medline databases, as well as the DATASUS database from January 2017 to January 2021. The descriptors used were: “Parkinson’s Disease”; “Comprehensive Health Care”; “Patient-Centered Care”. Results: In the period analyzed there were 3.536 hospitalizations for PD in Brazil with spending of R$14,937,372.3 highlighting the Southeast region that represents 49% of the total of these. Regarding sex, age and self-reported color/race, the most affected are men with 60.6%, individuals between 60 and 69 years (26.3%) and whites (49.9%). A total of 218 deaths were registered, with a mortality rate of 6.1%. Discussion: The PHC is responsible for part of the diagnosis and monitoring of patients with PD, being a central part in the coordination of care. It acts through the levels of care and improves the quality of life of its users through health actions, thus improving their quality of life. Conclusion: Basic health units must improve themselves through the continuous training of the professionals involved, thus resulting in a decrease in the mortality rate.

The study aims to analyze the working conditions of health professionals of Basic Health Units (BHU) of Fortaleza, Ceará, Brazil. BHUs are primary health care units that are the front door of the national public health system. The research analyzes working conditions of primary care auxiliary and/or technicians and their perceptions regarding working conditions and harassment. It is a cross-sectional survey of exploratory nature, using quantitative and qualitative methods. 120 mid-educational level background workers answered a questionnaire containing socio-economic information; an occupational stressors scale and the Negative Acts Questionnaire (NAQ). Nine technicians and auxiliaries participated in individual interviews. Observations of workplaces were also done. 2.5% of participants declared to have suffered workplace harassment. However, 11.7% reported negative acts towards them, weekly or daily in the last six months. The participants perceive their working conditions as precarious. They report employment instability, lack of equipment, low salaries, and long working journeys. They appear to worry about exercising their activities with prejudice to the services’ quality and to their health. The study points to the need for actions that bring egalitarian conditions in terms of employment to this category of workers, better working conditions, and financial and social recognition.

This study provides general information about the health economics and the health care expenditures in addition to its relations with economic growth and development. Specifically, this research focuses on the relation between health expenditures such as investments in medical sector, drugs etc. and economic growth in Turkey. Determining the structure of health expenditures and identifying the factors that influence such expenditures; “Child-Infant Mortality Rate”, “Life Expectancy at Birth and “Gross Mortality Rate are vitally important in terms of improvement of health indicators. Gross National Product per Capita and health expenditures per capita were considered as basic economic indicators as well. In this research, Turkey’s Gross National Product per capita in years between 2000–2014 and changes in basic health indicators of Turkey were analyzed and evaluated together. It also examined if a close relation exists between the expenditures for drugs and the total health expenditures within the whole system.

Current climate changes have a significant impact on the human health and life quality. Negative factors of climate change threaten basic health components that human needs, such as clean air, safe drinking water, food safety, hygiene and sanitary living conditions, and can sweep away decades of progress in the field of health care protection. Strategies for climate change adaptation, directed at the GHG reduction, provide co-benefits that significantly reduce health-care expenditures.

In what way and how can models for personalised support such as personal budgeting strengthen the implementation of the UN Convention on the Rights of Persons with Disabilities? Personal budgeting refers to a sum of money that is granted to the individual on the basis of an assessment of the need for service and calculation of a budget for this purpose. The individual can buy the service he needs for his budget. Personal budgeting is in use in social and health care in several countries. In the Nordic region, personal assistance is the main example of such solutions, but other models have also been tried and adopted in social and health care, such as systems of freedom of choice and increased opportunities for users to choose a provider. The report presents a number of personalised systems for support for people with disabilities that have been implemented in the Nordic countries and their experiences. The mapping was carried out jointly by the Nordic Welfare Center and the Finnish Institute for Health and Welfare (THL). The report will be considered when forming a proposal for a future reform of support and services for people with disabilities in Finland.

Economic reasons are among the basic explanatory factors of migration, whether international or internally within a country. In turn, migratory movements have effects on the economy in terms of economic growth in general, but also in the different markets (work, housing, consumer goods, etc.) and public services (education, health, social services, etc.). The purpose of this document is to offer an overview of these interactions between migration and the economy in the case of the Canary Islands. To do this, certain conceptual clarifications will be made initially involving the mutual determination of both processes, before later providing specifics with evidence on the Canarian case for the main issues considered: the economic reasons for migration, and its impact on economic growth, the labour market and the living conditions of the immigrant population. The final section alludes to the importance of the institutional framework that regulates these relations between migration and the economy, which are far from being interpretable as a mechanical relationship and isolated from the political sphere.

In the countries of the Lake Chad Basin, Boko Haram’s emergence has created major new security challenges for the region’s governments. Cameroon’s Far North region, the most populous in the country, is at the heart of these security issues. Since late 2020, Boko Haram has intensified attacks in Far North localities with assassinations targeting civilians, kidnappings, and looting in small towns along the Nigerian border. In response, the Cameroonian government has pursued a hardline strategy and militarized the affected localities. In addition to arbitrary arrests, prolonged pre-trial detention, prison overcrowding, and the death penalty are all sources of concern. This policy note outlines core findings from a case study of the Boko Haram ex-associates reintegration process in Cameroon. The note examines how existing community norms or mechanisms might be as useful as more standard approaches to disarmament, demobilization, and reintegration (DDR) in addressing challenges presented by Boko Haram ex-associates in Cameroon.

Review question / Objective: The type of study was clinical randomized controlled trial (RCT). The object of study is the patients with HFMD. There is no limit to gender and race. In the case of clear diagnosis standard, curative effect judgment standard and consistent baseline treatment, the experimental group was treated with pure oral liquid of traditional Chinese medicine(A: Fuganlin oral liquid, B: huangzhihua oral liquid, C: Lanqin oral liquid, D: antiviral oral liquid, E: Huangqin oral liquid, F: Pudilan oral liquid, G: Shuanghuanglian oral liquid.)and the control group was treated with ribavirin or any oral liquid of traditional Chinese medicine. The data were extracted by two researchers independently, cross checked and reviewed according to the pre-determined tables. The data extraction content is (1) Basic information (including the first author, published journal and year, research topic). (2) Relevant information (including number of cases, total number of cases, gender, age, intervention measures, course of treatment of the experimental group and the control group in the literature). (3) Design type and quality evaluation information of the included literature. (4) Outcome measures (effective rate, healing time of oral ulcer, regression time of hand and foot rash, regression time of fever, adverse reactions.). The seven traditional Chinese medicine oral liquids are comparable in clinical practice, but their actual clinical efficacy is lack of evidence-based basis. Therefore, the purpose of this study is to use the network meta-analysis method to integrate the clinical relevant evidence of direct and indirect comparative relationship, to make quantitative comprehensive statistical analysis and sequencing of different oral liquid of traditional Chinese medicine with the same evidence body for the treatment of the disease, and then to explore the advantages and disadvantages of the efficacy and safety of different oral liquid of traditional Chinese medicine to get the best treatment plan, so as to provide reference value and evidence-based medicine evidence for clinical optimization of drug selection. Condition being studied: Hand foot mouth disease (HFMD) is a common infectious disease in pediatrics caused by a variety of enteroviruses. Its clinical manifestations are mainly characterized by persistent fever, hand foot rash, oral herpes, ulcers, etc. Because it is often found in preschool children, its immune system development is not perfect, so it is very vulnerable to infection by pathogens and epidemic diseases, resulting in rapid progress of the disease. A few patients will also have neurogenic pulmonary edema Meningitis, myocarditis and other serious complications even lead to death, so effectively improve the cure rate, shorten the course of disease, prevent the deterioration of the disease as the focus of the study. In recent years, traditional Chinese medicine has played an important role in the research of antiviral treatment. Many clinical practices have confirmed that oral liquid of traditional Chinese medicine can effectively play the role of antiviral and improve the body's immunity.

The article explores the key vocabulary of 2020 in the network space of Ukraine. Texts of journalistic, official-business style, analytical publications of well-known journalists on current topics are analyzed. Extralinguistic factors of new word formation, their adaptation to the sphere of special and socio-political vocabulary of the Ukrainian language are determined. Examples show modern impressions in the media, their stylistic use and impact on public opinion in a pandemic. New meanings of foreign expressions, media terminology, peculiarities of translation of neologisms from English into Ukrainian have been clarified. According to the materials of the online media, a «dictionary of the coronavirus era» is provided. The journalistic text functions in the media on the basis of logical judgments, credible arguments, impressive language. Its purpose is to show the socio-political problem, to sharpen its significance for society and to propose solutions through convincing considerations. Most researchers emphasize the influential role of journalistic style, which through the media shapes public opinion on issues of politics, economics, education, health care, war, the future of the country. To cover such a wide range of topics, socio-political vocabulary is used first of all – neutral and emotionally-evaluative, rhetorical questions and imperatives, special terminology, foreign words. There is an ongoing discussion in online publications about the use of the new foreign token «lockdown» instead of the word «quarantine», which has long been learned in the Ukrainian language. Research on this topic has shown that at the initial stage of the pandemic, the word «lockdown» prevailed in the colloquial language of politicians, media personalities and part of society did not quite understand its meaning. Lockdown, in its current interpretation, is a restrictive measure to protect people from a dangerous virus that has spread to many countries; isolation of the population («stay in place») in case of risk of spreading Covid-19. In English, US citizens are told what a lockdown is: «A lockdown is a restriction policy for people or communities to stay where they are, usually due to specific risks to themselves or to others if they can move and interact freely. The term «stay-at-home» or «shelter-in-place» is often used for lockdowns that affect an area, rather than specific locations». Content analysis of online texts leads to the conclusion that in 2020 a special vocabulary was actively functioning, with the appropriate definitions, which the media described as a «dictionary of coronavirus vocabulary». Media broadcasting is the deepest and pulsating source of creative texts with new meanings, phrases, expressiveness. The influential power of the word finds its unconditional embodiment in the media. Journalists, bloggers, experts, politicians, analyzing current events, produce concepts of a new reality. The world is changing and the language of the media is responding to these changes. It manifests itself most vividly and emotionally in the network sphere, in various genres and styles.

A great deal of energy can be sourced both directly and indirectly from waste. For example, municipal waste with an energy content of around 60 petajoules is incinerated in Switzerland every year. The energy recovered directly from this waste covers around 4 % of the Swiss energy demand. However, the greatest potential offered by waste management lies in the recovery of secondary raw materials during the recycling process, thus indirectly avoiding the energy-intensive production of primary raw materials. In order to optimise the contribution to the energy turnaround made by waste management, as a first step, improvements need to be made with respect to the transparent documentation of material and cash flows, in particular. On the basis of this, prioritisation according to the energy efficiency of various recycling and disposal channels is required. Paper and cardboard as well as plastic have been identified as the waste fractions with the greatest potential for improvement. In the case of paper and cardboard, the large quantities involved result in considerable impact. With the exception of PET drinks bottles, plastic waste is often not separately collected and therefore offers substantial improvement potential. Significant optimisation potential has also been identified with regard to the energy efficiency of incineration plants. To allow municipal solid waste incineration (MSWI) plants to use the heat they generate more effectively, however, consumers of the recovered steam and heat need to be located close by. A decisive success factor when transitioning towards an energy-efficient waste management system will be the cooperation between the many stakeholders of the federally organised sector. On the one hand, the sector needs to be increasingly organised along the value chains. On the other hand, however, there is also a need to utilise the freedom that comes with federal diversity in order to test different solutions.

A set of experiments was conducted to expose different types of energized electrical cords for lamps, office equipment, and appliances to a developing room fire exposure. All of the cords were positioned on the floor and arranged in a manner to receive a similar thermal exposure. Six types of cords commonly used as power supply cords, extension cords, and as part of residential electrical wiring systems were chosen for the experiments. The non-metallic sheathed cables (NMB) typically found in residential electrical branch wiring were included to provide a link to previous research. The basic test design was to expose the six different types of cords, on the floor of a compartment to a growing fire to determine the conditions under which the cord would trip the circuit breaker and/or undergo an arc fault. All of the cords would be energized and installed on a non-combustible surface. Six cord types (18-2 SPT1, 16-3 SJTW, 12-2 NM-B, 12-3 NM-B, 18-3 SVT, 18-2 NISPT-2) and three types of circuit protection (Molded case circuit breaker (MCCB), combination Arc-fault circuit interrupter (AFCI), Ground-fault circuit interrupter (GFCI)) were exposed to six room-scale fires. The circuit protection was remote from the thermal exposure. The six room fires consisted of three replicate fires with two sofas as the main fuel source, two replicate fires with one sofa as the main fuel source and one fire with two sofas and MDF paneling on three walls in the room. Each fuel package was sufficient to support flashover conditions in the room and as a result, the impact on the cords and circuit protection was not significantly different. The average peak heat release rate of the sofa fueled compartment fires with gypsum board ceiling and walls was 6.8 MW. The addition of vinyl covered MDF wall paneling on three of the compartment walls increased the peak heat release rate to 12 MW, although most of the increased energy release occurred outside of the compartment opening. In each experiment during post flashover exposure, the insulation on the cords ignited and burned through, exposing bare conductor. During this period the circuits faulted. The circuit protection devices are not designed to provide thermal protection, and, thus, were installed remote from the fire. The devices operated as designed in all experiments. All of the circuit faults resulted in either a magnetic trip of the conventional circuit breaker or a ground-fault trip in the GFCI or AFCI capable circuit protection devices. Though not required by UL 1699, Standard for Safety for Arc-Fault Circuit-Interrupters as the solution for detection methodology, the AFCIs used had differential current detection. Examination of signal data showed that the only cord types that tripped with a fault to ground were the insulated conductors in non-metallic sheathed cables (12-2 NM-B and 12-3 NM-B). This was expected due to the bare grounding conductor present. Assessments of both the thermal exposure and physical damage to the cords did not reveal any correlation between the thermal exposure, cord damage, and trip type.

1.1 Macroeconomic summary Economic recovery has consistently outperformed the technical staff’s expectations following a steep decline in activity in the second quarter of 2020. At the same time, total and core inflation rates have fallen and remain at low levels, suggesting that a significant element of the reactivation of Colombia’s economy has been related to recovery in potential GDP. This would support the technical staff’s diagnosis of weak aggregate demand and ample excess capacity. The most recently available data on 2020 growth suggests a contraction in economic activity of 6.8%, lower than estimates from January’s Monetary Policy Report (-7.2%). High-frequency indicators suggest that economic performance was significantly more dynamic than expected in January, despite mobility restrictions and quarantine measures. This has also come amid declines in total and core inflation, the latter of which was below January projections if controlling for certain relative price changes. This suggests that the unexpected strength of recent growth contains elements of demand, and that excess capacity, while significant, could be lower than previously estimated. Nevertheless, uncertainty over the measurement of excess capacity continues to be unusually high and marked both by variations in the way different economic sectors and spending components have been affected by the pandemic, and by uneven price behavior. The size of excess capacity, and in particular the evolution of the pandemic in forthcoming quarters, constitute substantial risks to the macroeconomic forecast presented in this report. Despite the unexpected strength of the recovery, the technical staff continues to project ample excess capacity that is expected to remain on the forecast horizon, alongside core inflation that will likely remain below the target. Domestic demand remains below 2019 levels amid unusually significant uncertainty over the size of excess capacity in the economy. High national unemployment (14.6% for February 2021) reflects a loose labor market, while observed total and core inflation continue to be below 2%. Inflationary pressures from the exchange rate are expected to continue to be low, with relatively little pass-through on inflation. This would be compatible with a negative output gap. Excess productive capacity and the expectation of core inflation below the 3% target on the forecast horizon provide a basis for an expansive monetary policy posture. The technical staff’s assessment of certain shocks and their expected effects on the economy, as well as the presence of several sources of uncertainty and related assumptions about their potential macroeconomic impacts, remain a feature of this report. The coronavirus pandemic, in particular, continues to affect the public health environment, and the reopening of Colombia’s economy remains incomplete. The technical staff’s assessment is that the COVID-19 shock has affected both aggregate demand and supply, but that the impact on demand has been deeper and more persistent. Given this persistence, the central forecast accounts for a gradual tightening of the output gap in the absence of new waves of contagion, and as vaccination campaigns progress. The central forecast continues to include an expected increase of total and core inflation rates in the second quarter of 2021, alongside the lapse of the temporary price relief measures put in place in 2020. Additional COVID-19 outbreaks (of uncertain duration and intensity) represent a significant risk factor that could affect these projections. Additionally, the forecast continues to include an upward trend in sovereign risk premiums, reflected by higher levels of public debt that in the wake of the pandemic are likely to persist on the forecast horizon, even in the context of a fiscal adjustment. At the same time, the projection accounts for the shortterm effects on private domestic demand from a fiscal adjustment along the lines of the one currently being proposed by the national government. This would be compatible with a gradual recovery of private domestic demand in 2022. The size and characteristics of the fiscal adjustment that is ultimately implemented, as well as the corresponding market response, represent another source of forecast uncertainty. Newly available information offers evidence of the potential for significant changes to the macroeconomic scenario, though without altering the general diagnosis described above. The most recent data on inflation, growth, fiscal policy, and international financial conditions suggests a more dynamic economy than previously expected. However, a third wave of the pandemic has delayed the re-opening of Colombia’s economy and brought with it a deceleration in economic activity. Detailed descriptions of these considerations and subsequent changes to the macroeconomic forecast are presented below. The expected annual decline in GDP (-0.3%) in the first quarter of 2021 appears to have been less pronounced than projected in January (-4.8%). Partial closures in January to address a second wave of COVID-19 appear to have had a less significant negative impact on the economy than previously estimated. This is reflected in figures related to mobility, energy demand, industry and retail sales, foreign trade, commercial transactions from selected banks, and the national statistics agency’s (DANE) economic tracking indicator (ISE). Output is now expected to have declined annually in the first quarter by 0.3%. Private consumption likely continued to recover, registering levels somewhat above those from the previous year, while public consumption likely increased significantly. While a recovery in investment in both housing and in other buildings and structures is expected, overall investment levels in this case likely continued to be low, and gross fixed capital formation is expected to continue to show significant annual declines. Imports likely recovered to again outpace exports, though both are expected to register significant annual declines. Economic activity that outpaced projections, an increase in oil prices and other export products, and an expected increase in public spending this year account for the upward revision to the 2021 growth forecast (from 4.6% with a range between 2% and 6% in January, to 6.0% with a range between 3% and 7% in April). As a result, the output gap is expected to be smaller and to tighten more rapidly than projected in the previous report, though it is still expected to remain in negative territory on the forecast horizon. Wide forecast intervals reflect the fact that the future evolution of the COVID-19 pandemic remains a significant source of uncertainty on these projections. The delay in the recovery of economic activity as a result of the resurgence of COVID-19 in the first quarter appears to have been less significant than projected in the January report. The central forecast scenario expects this improved performance to continue in 2021 alongside increased consumer and business confidence. Low real interest rates and an active credit supply would also support this dynamic, and the overall conditions would be expected to spur a recovery in consumption and investment. Increased growth in public spending and public works based on the national government’s spending plan (Plan Financiero del Gobierno) are other factors to consider. Additionally, an expected recovery in global demand and higher projected prices for oil and coffee would further contribute to improved external revenues and would favor investment, in particular in the oil sector. Given the above, the technical staff’s 2021 growth forecast has been revised upward from 4.6% in January (range from 2% to 6%) to 6.0% in April (range from 3% to 7%). These projections account for the potential for the third wave of COVID-19 to have a larger and more persistent effect on the economy than the previous wave, while also supposing that there will not be any additional significant waves of the pandemic and that mobility restrictions will be relaxed as a result. Economic growth in 2022 is expected to be 3%, with a range between 1% and 5%. This figure would be lower than projected in the January report (3.6% with a range between 2% and 6%), due to a higher base of comparison given the upward revision to expected GDP in 2021. This forecast also takes into account the likely effects on private demand of a fiscal adjustment of the size currently being proposed by the national government, and which would come into effect in 2022. Excess in productive capacity is now expected to be lower than estimated in January but continues to be significant and affected by high levels of uncertainty, as reflected in the wide forecast intervals. The possibility of new waves of the virus (of uncertain intensity and duration) represents a significant downward risk to projected GDP growth, and is signaled by the lower limits of the ranges provided in this report. Inflation (1.51%) and inflation excluding food and regulated items (0.94%) declined in March compared to December, continuing below the 3% target. The decline in inflation in this period was below projections, explained in large part by unanticipated increases in the costs of certain foods (3.92%) and regulated items (1.52%). An increase in international food and shipping prices, increased foreign demand for beef, and specific upward pressures on perishable food supplies appear to explain a lower-than-expected deceleration in the consumer price index (CPI) for foods. An unexpected increase in regulated items prices came amid unanticipated increases in international fuel prices, on some utilities rates, and for regulated education prices. The decline in annual inflation excluding food and regulated items between December and March was in line with projections from January, though this included downward pressure from a significant reduction in telecommunications rates due to the imminent entry of a new operator. When controlling for the effects of this relative price change, inflation excluding food and regulated items exceeds levels forecast in the previous report. Within this indicator of core inflation, the CPI for goods (1.05%) accelerated due to a reversion of the effects of the VAT-free day in November, which was largely accounted for in February, and possibly by the transmission of a recent depreciation of the peso on domestic prices for certain items (electric and household appliances). For their part, services prices decelerated and showed the lowest rate of annual growth (0.89%) among the large consumer baskets in the CPI. Within the services basket, the annual change in rental prices continued to decline, while those services that continue to experience the most significant restrictions on returning to normal operations (tourism, cinemas, nightlife, etc.) continued to register significant price declines. As previously mentioned, telephone rates also fell significantly due to increased competition in the market. Total inflation is expected to continue to be affected by ample excesses in productive capacity for the remainder of 2021 and 2022, though less so than projected in January. As a result, convergence to the inflation target is now expected to be somewhat faster than estimated in the previous report, assuming the absence of significant additional outbreaks of COVID-19. The technical staff’s year-end inflation projections for 2021 and 2022 have increased, suggesting figures around 3% due largely to variation in food and regulated items prices. The projection for inflation excluding food and regulated items also increased, but remains below 3%. Price relief measures on indirect taxes implemented in 2020 are expected to lapse in the second quarter of 2021, generating a one-off effect on prices and temporarily affecting inflation excluding food and regulated items. However, indexation to low levels of past inflation, weak demand, and ample excess productive capacity are expected to keep core inflation below the target, near 2.3% at the end of 2021 (previously 2.1%). The reversion in 2021 of the effects of some price relief measures on utility rates from 2020 should lead to an increase in the CPI for regulated items in the second half of this year. Annual price changes are now expected to be higher than estimated in the January report due to an increased expected path for fuel prices and unanticipated increases in regulated education prices. The projection for the CPI for foods has increased compared to the previous report, taking into account certain factors that were not anticipated in January (a less favorable agricultural cycle, increased pressure from international prices, and transport costs). Given the above, year-end annual inflation for 2021 and 2022 is now expected to be 3% and 2.8%, respectively, which would be above projections from January (2.3% and 2,7%). For its part, expected inflation based on analyst surveys suggests year-end inflation in 2021 and 2022 of 2.8% and 3.1%, respectively. There remains significant uncertainty surrounding the inflation forecasts included in this report due to several factors: 1) the evolution of the pandemic; 2) the difficulty in evaluating the size and persistence of excess productive capacity; 3) the timing and manner in which price relief measures will lapse; and 4) the future behavior of food prices. Projected 2021 growth in foreign demand (4.4% to 5.2%) and the supposed average oil price (USD 53 to USD 61 per Brent benchmark barrel) were both revised upward. An increase in long-term international interest rates has been reflected in a depreciation of the peso and could result in relatively tighter external financial conditions for emerging market economies, including Colombia. Average growth among Colombia’s trade partners was greater than expected in the fourth quarter of 2020. This, together with a sizable fiscal stimulus approved in the United States and the onset of a massive global vaccination campaign, largely explains the projected increase in foreign demand growth in 2021. The resilience of the goods market in the face of global crisis and an expected normalization in international trade are additional factors. These considerations and the expected continuation of a gradual reduction of mobility restrictions abroad suggest that Colombia’s trade partners could grow on average by 5.2% in 2021 and around 3.4% in 2022. The improved prospects for global economic growth have led to an increase in current and expected oil prices. Production interruptions due to a heavy winter, reduced inventories, and increased supply restrictions instituted by producing countries have also contributed to the increase. Meanwhile, market forecasts and recent Federal Reserve pronouncements suggest that the benchmark interest rate in the U.S. will remain stable for the next two years. Nevertheless, a significant increase in public spending in the country has fostered expectations for greater growth and inflation, as well as increased uncertainty over the moment in which a normalization of monetary policy might begin. This has been reflected in an increase in long-term interest rates. In this context, emerging market economies in the region, including Colombia, have registered increases in sovereign risk premiums and long-term domestic interest rates, and a depreciation of local currencies against the dollar. Recent outbreaks of COVID-19 in several of these economies; limits on vaccine supply and the slow pace of immunization campaigns in some countries; a significant increase in public debt; and tensions between the United States and China, among other factors, all add to a high level of uncertainty surrounding interest rate spreads, external financing conditions, and the future performance of risk premiums. The impact that this environment could have on the exchange rate and on domestic financing conditions represent risks to the macroeconomic and monetary policy forecasts. Domestic financial conditions continue to favor recovery in economic activity. The transmission of reductions to the policy interest rate on credit rates has been significant. The banking portfolio continues to recover amid circumstances that have affected both the supply and demand for loans, and in which some credit risks have materialized. Preferential and ordinary commercial interest rates have fallen to a similar degree as the benchmark interest rate. As is generally the case, this transmission has come at a slower pace for consumer credit rates, and has been further delayed in the case of mortgage rates. Commercial credit levels stabilized above pre-pandemic levels in March, following an increase resulting from significant liquidity requirements for businesses in the second quarter of 2020. The consumer credit portfolio continued to recover and has now surpassed February 2020 levels, though overall growth in the portfolio remains low. At the same time, portfolio projections and default indicators have increased, and credit establishment earnings have come down. Despite this, credit disbursements continue to recover and solvency indicators remain well above regulatory minimums. 1.2 Monetary policy decision In its meetings in March and April the BDBR left the benchmark interest rate unchanged at 1.75%.